diff --git a/resources/views/form/rapport-glenmarkcv/1779081191-58b7260b-40d2-4f1f-950c-3b327701ec2d.blade.php b/resources/views/form/rapport-glenmarkcv/1779081191-58b7260b-40d2-4f1f-950c-3b327701ec2d.blade.php
index c160af94..9fc149ae 100644
--- a/resources/views/form/rapport-glenmarkcv/1779081191-58b7260b-40d2-4f1f-950c-3b327701ec2d.blade.php
+++ b/resources/views/form/rapport-glenmarkcv/1779081191-58b7260b-40d2-4f1f-950c-3b327701ec2d.blade.php
@@ -44,18 +44,7 @@
                                 @if($id)
                                 <input type="hidden" name="id" value="{{$id}}">
                                 @endif
-                                @if(isset($form->manager_can_submit) && $form->manager_can_submit == true)
-                                <div class="col-md-12 mb-2">
-                                    <label for="field-user_id" class="form-label"> Select User / Territory <span class="text-danger">*</span> </label>
-                                    <select class="form-control" id="field-user_id" name="user_id" required>
-                                        <option value=""> -- Select -- </option>
-                                        @foreach($form->users as $option)
-                                        <option value="{{$option->value}}" hierarchy="{{$option->hierarchy_id}}" {{isset($question->value) && $question->value == $option->value ? 'selected':''}}>{{$option->display}}</option>
-                                        @endforeach
-                                    </select>
-                                    <input type="hidden" id="field-hierarchy_id" name="hierarchy_id" value="">
-                                </div>
-                                @endif
+                                
 
                                 @foreach($questions as $question)
                                     <div class="col-md-12 mb-2">
@@ -68,24 +57,31 @@
                                         @case('email')
                                         @case('tel')
                                         @case('date')
+                                                <input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }}
+                                             {{ in_array($question->code, ['msl-code', 'speciality']) ? 'readonly' : '' }}
+                                              value="{{isset($question->value)?$question->value:''}}">
+                                            @break
+
+                                        @case('number')
+
                                             <input
-                                                type="{{$question->type}}"
+                                                type="number"
+                                                min="0"
+                                                max="9999999999"
+                                                step="1"
+
+                                                oninput="this.value = this.value.replace(/[^0-9]/g, '')"
+
                                                 id="field-{{$question->code}}"
                                                 name="{{$question->code}}"
                                                 class="form-control"
 
-                                                {{$question->required == 'yes' ? 'required' : ''}}
+                                                {{$question->required == 'yes'?'required':'' }}
 
-                                                {{$question->code == 'msl_code' ? 'readonly' : ''}}
+                                                value="{{isset($question->value)?$question->value:0}}"
 
-                                                {{$question->code == 'speciality' ? 'readonly' : ''}}
+                                                {{ $question->code == 'total-ziten-rx' ? 'readonly' : '' }}>
 
-                                                value="{{isset($question->value)?$question->value:''}}">
-
-                                            @break
-
-                                        @case('number')
-                                            <input type="{{$question->type}}" min="0" max="9999999999" step="1" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }}  value="{{isset($question->value)?$question->value:0}}">
                                             @break
                                         @case('textarea')
                                             <textarea id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }}>{{isset($question->value)?$question->value:''}}</textarea>
@@ -234,40 +230,17 @@
 <script src="{{asset('assets/libs/sweetalert2/sweetalert2.min.js')}}"></script>
 <script type="text/javascript">
     jQuery(document).ready(function($){
-        $('#field-user_id').change(function(){
-            let hierarchy = $('option:selected', this).attr('hierarchy');
-            $('#field-hierarchy_id').val(hierarchy)
-            event.preventDefault();
-            $.ajax({
-                type: "GET",
-                url: '/form/getdoctorlist?partition={{$form->partition}}&hierarchy='+hierarchy,
-                processData: false,
-                contentType: false,
-                success: function( data ) {
-                    $("#pageloader").fadeOut();
-                    $('#field-contact_id').html('')
-                    $('#field-contact_id').append($("<option></option>").attr("value",'').text('-- Select --'));
-                    for(let itm of data) {
-                        $('#field-contact_id').append(
-                            $("<option></option>")
-                                .attr("value", itm.value)
-                                .attr("msl_code", itm.msl_code)
-                                .attr("speciality", itm.speciality)
-                                .text(itm.display)
+        
 
-                        );                    }                    
-                },
-            });
-
-            console.log(hierarchy)
-        })
-         $("#field-contact_id").change(function(){
-            let selected = $('option:selected', this);
-            $('#field-msl_code').val(selected.attr('msl_code'));
-            $('#field-speciality').val(selected.attr('speciality'));
-        });
+        $(document).on(
+            'input',
+            '#field-ziten-m-20-mg-1000-mg-rx, #field-ziten-m-20-mg-500-mg-rx, #field-ziten-rx',
+            function () {
 
+                this.value = this.value.replace(/[^0-9]/g, '');
 
+            }
+        );
 
 
         $(document).on('change', '#field-contact_id', function () {
@@ -346,15 +319,12 @@
             });
         });
 
-            var today = new Date();
-            var dd = String(today.getDate()).padStart(2, '0');
-            var mm = String(today.getMonth() + 1).padStart(2, '0');
-            var yyyy = today.getFullYear();
-            today = yyyy + '-' + mm + '-' + dd;
+            $('input[type="date"]').attr(
+                'max',
+                new Date().toISOString().split("T")[0]
+            );
 
-            var plandateField = document.getElementById('field-record_date');
-
-            plandateField.setAttribute('max', today);
+            
     });
 </script>
 </body>